Medical/Clinical Study: Epidemiologic Study of Environmental and Behavioral Factors Associated with Injury

Goals:

To provide descriptive data on victim outcomes and environmental and behavioral risk and protective factors.

Who would use the data?

Medical and public health professionals, and other community policymakers and planners who must prepare for future mass casualty events.

Example:

Mellor SG, Cooper GJ. Analysis of 828 servicemen killed or injured by explosion in Northern Ireland 1970-84: the Hostile Action Casualty System. Br J Surg 1989;76(10): 1006-10.

Research questions:

• What are the numbers, percentage distributions and rates of all event-related nonfatal injuries, serious non-fatal injuries, and fatal injuries?
• What are the characteristics of the injured persons (e.g., age, gender, race/ethnicity,)? How do these event-related measures compare with baseline estimates prior to the event?
• What were the causes of the injuries? What was the specific mechanism of injury?
• How many persons injured during the event were treated and released, hospitalized, transferred to another facility, died?
• Where did victims injured in the event go for emergency care and how did they get there?
• What were the circumstances of the event-related injury incidents, such as location of victim relative to event, activity at the time of injury, work-relatedness, objects/substances involved, and time of day injured?
• How many event-related injuries resulted in permanent impairment, lost activity days, lost workdays, quality of life, and other measures of short- and long-term disability?

Methods:

• Target population: Victims directly impacted by the event who sought treatment at the ED or died
• Study design: Cross-sectional record abstraction, other data collection as needed
• Sampling plan: Collect data on all victims, or sample as needed.

Data sources:

• Primary data source: Police, emergency medical services (EMS), ED, hospital, ME records
• Secondary data source: Red Cross, DMAT teams

Sample variables:

Age, race/ethnicity, sex, type of injury, fatal or non-fatal, cause of injury, time lapse between injury and treatment, source/location of care, treatment, hospitalized or released, mode of arrival at treatment facility, location when injured or killed, activity at time of injury, work-relatedness, objects/substances involved, time of day injured, physical impairment, lost activity days, lost work days, change in quality of life.

Time frame for initiating study:

One to four weeks after event.

Potential partners/collaborators:

• State and local health departments
• Local university researchers, especially schools of public health
• CDC, NCIPC staff
• Red Cross

IRB needed:

Depends upon how data will be used.